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Diagnosis
| Etiologic Diagnosis | |||
| Diagnosis | Epidemiology & Predisposing Factors | Natural History of Disease | Signs & Symptoms |
| Adenovirus | Relatively common & highly contagious. May occur in epidemics. Usually transmitted through direct physical contact with infected person or object. | Self-limited with improvement within 5-14 days | Abrupt onset bilateral conjunctival injection (one eye may precede the other by a few days) with follicular reaction especially of the inferior tarsal conjunctiva, watery discharge, preauricular lymphadenopathy. Occasionally present: petechial or subconjunctival hemorrhage, pseudomembrane or true membrane. Superficial multifocal punctate keratitis may occur followed by subepithelial opacities. Filamentary keratitis may occur in patients who maintain their lids closed to minimize ocular discomfort. |
| Herpes simplex | Primary infection from infected individual | Usually subsides in 4-7 days without treatment unless there are complications | Usually unilateral. Conjunctival injection with follicular reaction, watery discharge. Primary infection: Follicular conjunctivitis & lid vesicles (blepharodermatitis). May have pseudomembrane, dendritic keratitis, preauricular lymphadenopathy. |
| Molluscum contagiosum | Predominantly older children. Can also occur in immunocompromised patients. | Conjunctivitis is associated with eyelid lesions which can spontaneously disappear or may last months to years | Typically unilateral but can be bilateral. Single or multiple shiny, dome shaped umbilicated lesions on the eyelid or lid margin. Mild to severe follicular reaction, punctate epithelial keratitis. May have corneal pannus in long-standing disease. |
Laboratory Tests
- Viral cultures & immunodiagnostic tests are not routinely used to establish diagnosis
- Nucleic acid amplification tests including polymerase chain reaction (PCR) may be available for certain viruses, but they are not validated for ocular specimens
